#30 - pulp necrosis / SAP
Good amount of attachment loss, but no mobility.
Would anyone extract? I think this one can last more years.
2 3047 minutes ago
This patient presented to the clinic in severe pain on the UL side that had been keeping him up for the past few nights. #14 SIP/SAP. Upon delivery of local anesthetics via maxillary infiltration, he felt immediate relief at just being numb. He had a previous filling that had come out some time ago. Caries leveraged access. V2H 25/06 files in the buccals and an apical size 40 in the palatal. WVC. AH plus sealer. ————————————————————
Why caries leveraged and not a traditional access? There has been a trend for conservation of tooth structure in endodontics from an access standpoint and shaping standpoint with contemporary shifts in mindset. In the desk reference titled “Best Practices in Endodontics” edited by Richard S. Schwartz and Venkat Canakapalli, they give key points in regards to rational for conservative endodontics. Retaining and preserving pericervical dentin (4mm of dentin coronal and apical to crestal bone) is of the utmost importance. It provides strength, resistance and retention form for crowns. They go on to state that, “Aggressive straightening of the orifices to achieve straight-line access can compromise the thickness of the cervical dentin and the structural integrity of the tooth.” All this can hopefully extend the lifespan of the teeth that we are working on.🤓
6 28an hour ago
WHAT? WOW! Watching this documentary makes my jaw hurt... lol. Root canal are cause of most health problems like heart attached, cancer, anxiety, backpain etc. 😯😣🙁 #netflix#documentary#rootcause#rootcanal
Dens invaginatus, also known as dens in dente ("tooth within a tooth") is a rare dental malformation found in teeth where there is an infolding of enamel into dentine. This interesting case highlights a conservative treatment of a Type I DI (Oehlers, 1957) in order to allow complete root formation. The 12 month follow up radiograph revealed a successful Apexogenesis. #endodontics#endodontista#rootcanal
FAQs About Treatment That Can Save Your Tooth
The article is great, however we always advised speaking with one of the BCS team members to get answers for your specific needs.
Have a great week everyone!
The SHORT Case Of The Day!
Tooth #19 ~ Perio or Endo?
Patient came in pain on tooth #19 referred by his dentist. His dentist noticed there was furcation breakdown radiographically but no signficant probing. His dentist was concerned about a possible fracture or periodontal defect that may require an extraction and implant.
The diagnosis on this case was a necrotic pulp with acute apical periodontitis and furcation pathology. Tooth was treated in 2 visits with calcium hydroxide and patient returned asymptomatic. There was no crack noted or periodontal defect noted using the microscope. The case was obturated with Kerr EWT sealer and warm vertical condensation. Patient returned for a 6 month recall with nice healing in the furcation area. No periodontal intervention was needed. This was an endo issue manifesting as a perio issue. There was an accessory canal in which the bacteria went into the furcal area causing breakdown. DeDeus wrote a classic paper about this in the JOE (1975) which said accessory canals are present about 75% of the time with only 15% in the coronal area. Vertucci wrote papers and mentioned the same percentages. Notice I wasn't able to "pop" the furcation canal but the area still healed anyway. A classic study by Ricucci and Sequira in 2010 (JOE) said that being able to inject filling material into the lateral canals or "pop" them had no theraputic benefit or superiority of the case.
Dr. Rico D. Short
Board Certified Endodontist / Author / Speaker
Apex Endodontics P.C / Atlanta #drricoshort#rootcanalspecialisttothestars#drricoshortspeaks#rootcanal
3 223 hours ago
“We don’t change the test questions from year to year, we change which answers are correct.” This is one of my favorite quotes from the great Sam Seltzer (1914-2014) that accurately depicts our specialty - the primary goal of our treatment has always been to eliminate/prevent apical periodontitis (Orstavik), but the means of achieving so changes constantly throughout time.
In infected immature teeth with an open apex, the traditional treatment option would be apexification with long-term Ca(OH)2 dressing. In the early 2000s, utilizing the concept of the revascularization of sterile necrotic teeth after traumatic injuries (FM Andreasen), with the discovery of SCAP by Shi’s group and several successful case reports (Iwaya, Banchs) - begin the era of regenerative endodontics
Pic 2 summarizes the concept of regen procedure. If successful, we would get root length/width growth throughout time, documented by numerous lits (eg Bose). What sometimes is overlooked though is the first and KEY step - proper disinfection. RCTs (or eliminating apical periodontitis) can be successful even when leaving bacteria behind (Sjogren), but regeneration most likely will not
Pic 3 was the research project I did back at school also showing a big drawback of revasc - when in contact with blood, even newer generations of bioceramic material will cause the crown to discolor throughout time (Shokouhinejad)
To sum up, young female, long-standing infection...etc all contributed to my choice of doing apical plug w/ ERRM putty. But there is no right or wrong here I think
1 yr f/u shows significant healing of the lesion. #9 probably fractured and the apical portion remained vital the whole time. I think my composite should've extended deeper to strengthen the CEJ better (Trope) or replace GP with resin bonded fiber posts
Regenerative endodontics is great, but apexification with bioceramics is still a viable option, that is gaining popularity again and has shown to have great long-term outcomes - check out the amazing case series by Dr. Marga Ree in 2017 J Endod. Now we just have to wait and see how this one turns out...
IA Intricate Anatomy Previous Root canal completed a few years ago by a specialist and looks well done! It’s the case that comes back and we wonder why it failed? I now know why it failed! I completed this case today by a Traditional Re Treatment 1 visit, except the canal system was completely irrigated and debrided by Acoustic Energy and Fluid Dynamics. 300CC/ML NAOCL 120CC/ML of EDTA = Sound results! #rootcanal#endodontics#endodontia#endodoncia#gentlewave#gentlewaveprocedure#liveendo
The power of 3-D. This patient had root canal treatment completed a few months earlier and was still having pain. Our 3-D imaging shows a missed canal. The third canal was discovered and the other two canals were retreated at the same time. The patient's discomfort finally resolved, and she is finally able to get her permanent crown. #cbct#3d#technology#rootcanal#retreatment#happypatient#healthyroots#dentistry
Got the son in the hot seat today. Tooth pain is no fun, and someone didn’t want me to take his pic 😂.
Luckily, got some amazing people in my corner, like Dr. Nathan Woods at Red Mountain Endodontics to help out. Found out there was an infection, and a root canal therapy was needed. Got my boy taken care of, and know he is going to feel so much better in the long run! #redmoutainendodontics#smile#dental#rootcanal#rootcanaltreatment#mesaarizona
0 83 hours ago
1 303 hours ago
( tracing) ردیابی کانال ریشه پیدا نشده، که باعث آیجاد ابسه و فیستول شده بود.
تصویر سوم بهبودی آبسه پس از پیدا کردن و پاکسازی کامل کانال ( mb2).